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  • ISSN: 2378-9344
    Volume 5, Issue 2
    Research Article
    Jayesh Betala, Jeoung Soo Lee, Eugene M. Langan III, and Martine LaBerge*
    Purpose: Endovascular stents to manage plaque formation in arteries cause restenosis with smooth muscle cells (SMCs) proliferation. Estrogen is known to exert cardiovascular protective effects and antiproliferative effects on vascular smooth muscle cells in vitro as well as in vivo. In this study, we evaluated the effect of estrogen (17-β estradiol) delivered withiopromide-370 (17-βE/Iop) on SMCs proliferation, apoptosis, protein expression and hypertrophy under static and dynamic strain conditions.
    Methods: Rat aortic SMCs were cultured in static and dynamic conditions for 24 hours, followed by short-term treatment with 17-βE/Iop. At a predetermined time, SMCs were analyzed for proliferation using MTT assay, apoptosis employing TUNEL assay, and hypertrophy by immunostaining for SM a-actin, and SM22a expression by western blot.
    Results: Rat aortic SMCs proliferation was significantly inhibited after treatment of 17-βE/Iop for 5 minutes, and inhibition was maintained up to 7 days in static conditions and up to 3 days in dynamic conditions as compared to untreated control. For apoptosis, hypertrophy, and protein expression levels, SMCs treated with 17-βE/Iop were not significantly different from untreated SMCs in both static and dynamic conditions.
    Conclusion: Estrogen with iopromide-370 (17-βE/Iop) showed significant SMCs proliferation inhibition with 5 minutes' treatment; however, no other effects were observed after treatment in both static and dynamic conditions.
    Lisa Schuler*, Iris Weingard, Martin Kiderlen, Athansios Theodoridis, Karsten Hartmann, and Venenzentrum Freiburg
    Objectives: In addition to combined high ligation and stripping or pure sclerotherapy, various endovenous thermal procedures are now available for treatment. Laser ablation (EVLA 1470nmTM), Radio frequency ablation (RFITT and ClosureFastTM) and superheated steam are compared in the present study.
    In this prospective study between 2009 and 2013, the GSV was ablated in 297 patients using one of four methods: EVLA 1470nm (n=75), Closure Fast (n=94), RFITT (n=81) or superheated steam (n=47). The recurrence rate after treatment was defined as the primary endpoint. Follow-up examinations with duplex ultrasound took place 14 days, 3 months and 1 year post-operatively, and thereafter annually with average follow-up time of 3.8 years and a follow-up rate of 81%.
    Results: At the time of the last follow-up examination, the following complete closure rates of treated GSV were found: EVLA 89%, RFITT 57%, superheated steam 56% and Closure Fast 94%. Serious complications occurred only with superheated steam (necrosis at the puncture site). The median pain intensity recorded 14 days post-operatively was 1-3 on a scale of 1-10 in all groups. Both the CIVIQ score and the VCSS were significantly improved by all endovenous thermal methods. In 5-12% of cases, reflux was found in the previously non-reflexive AASV.
    Conclusions: EVLA and Closure Fast are indicated for the treatment of GSV incompetence with high success rates, comparable to the results with high ligation and stripping. The RFITT and superheated steam methods presented with significantly lower closure rates.
    Adeola T. Adetiloye, Olusola C. Famurewa, Adeleye D. Omisore*, Anthony O. Akintomide, and Adeoye J. Adetiloye
    Background: Primary hypertension (PHT) has been linked to vascular endothelial dysfunction (ED) which is an initial step in the development of atherosclerosis. Brachial artery percentage flow mediated dilatation (%FMD) is widely used as a surrogate marker to assess endothelial function (EF). We aimed to evaluate %FMD in subjects with PHT and determine effect of additional co-existing traditional cardiovascular risk factors (CVRFs) on %FMD in them.
    Methods: Brachial artery % FMD of 125 subjects with PHT and 125 age and sex matched apparently healthy controls (HC) were measured by high resolution B-mode ultrasound. Their demographic data, clinical history, anthropometric and laboratory parameters like serum fasting lipid profile (FLP) and fasting blood glucose (FBG) were also taken. Data was analysed using SPSS version 22 and p value <0.5 considered as statistically significant.
    Results: Percentage FMD was significantly worse in subjects with PHT (2.30 ± 2.65) compared to the HC (7.10 ± 2.65), (p<0.01). Increasing age, male gender and postmenopausal status in the HC (all p<0.01) while increasing age and postmenopausal status in PHT (all p<0.01) subjects were associated with worse %FMD. In the PHT subjects, poor blood pressure (BP) control (p=0.014), duration of PHT (p=0.033) of more than 10 years and presence (p=0.016) of one additional co-existing traditional CVRF which were either age or menopausal status, further worsened %FMD. More than one co-existing CVRFs with PHT had no further effect on %FMD (p>0.05).
    Conclusion: There is worsening of % FMD in PHT compared to HC subjects. The presence of increasing age or postmenopausal status, poor BP control and duration of PHT further worsen %FMD in PHT subjects.
    Cases Report
    Ana de la C. Roman Montoya*, Clara Martinez Manrique, Noraima Contreras Vega, and Ivelisa Flores Ramirez
    A descriptive intervention was made of cases with varicose ulcers in the lower extremities, which were treated with different systemic antibiotics and topically another range of drugs, after a torpid evolution of the lesion that ranged between 3 and 12 months. The CM-95 solution was applied as fomentations and was administered orally, preserving the antibiotic therapy, until the total resolution of the lesion with a reduction of the cure time from 15 to 45 days. The effectiveness of the applied treatment with a positive evolution until complete healing was demonstrated, due to the immunomodulatory, anti-inflammatory and healing effects of the magnetically treated solution.
    Anca Sabina Petras, Marilena Spiridon, Irina Iuliana Costache* and Antoniu Octavian Petris
    We present a case of a young female associating multiple thromboses, both in the arterial and venous territories, in the context of acquired and hereditary thromboembolic risk factors, respectively, pregnancy and hereditary thrombophilia. Identification of the prothrombotic factors responsible for acquired or hereditary thrombophilias is justified in this case by the appearance of arterial thrombosis in a young woman without atherosclerotic risk factors, such as smoking, dyslipidemia, diabetes mellitus, hypertension, to which we finally discovered two heterozygous mutations in the hereditary thrombophilia profile. Thrombophilias can cause multiple or recurrent thromboses, in unusual sites, sometimes severe, with dramatic consequences, therefore the lifelong oral anticoagulation decision should be weighed according to the benefit/risk ratio.
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